Published September 12, 2012
President Obama is wooing seniors with promises to protect Medicare as they've known it. On the defensive because of the $716 billion his health care law takes from Medicare, Obama assures seniors he's cutting payments to hospitals and other providers, not their benefits.
Don't be bamboozled. It's illogical to think that reducing what a hospital is paid to treat seniors won't harm their care. A mountain of scientific evidence proves the cuts will worsen the chance that an elderly patient survives a hospital stay and goes home. It’s reasonable to conclude that tens of thousands of seniors will die needlessly each year.
Under ObamaaCare, hospitals, hospice care, dialysis centers, and nursing homes will be paid less to care for the same number of seniors than if the health law had not been enacted. Payments to doctors will also be cut.
Scientific evidence published in the Annals of Internal Medicine, a leading scientific journal, suggests that forcing hospitals to spend less on elderly patients will produce deadly results.
Exhaustive data on over two million elderly patients treated at 208 California hospitals from 1999 to 2008 show that elderly patients treated in low spending hospitals (bottom quintile) get less care and have a worse chance of surviving and leaving the hospital than elderly patients with the same diagnosis treated at higher spending hospitals. The research, sponsored by the National Institute on Aging and RAND and published in 2011 found that heart attack patients were 19% more likely to die at low spending hospitals.
Over a four year period, 13,613 seniors with pneumonia, stroke, heart attacks and other common conditions who died at low spending hospitals would have recovered and gone home had they been treated at a higher spending institution.(Annals of Internal Medicine, February 1, 2011) That’s the death toll in one state with about 10% of the Medicare population.
Ignoring this evidence, the Obama administration is pressuring hospitals in all fifty states to imitate low spending hospitals. In addition to the across the board cuts in future payments to hospitals,very soon, beginning in October, 2012, the Obama administration will reward hospitals that spend the least per senior,and penalize those that spend more. For several years, the Centers for Medicare and Medicaid have measured hospital quality, including infection rates. But Section 3001 of the Obama health care law adds "Medicare spending per beneficiary" as a measure for the first time. Hospital administrators express alarm that the measure includes not only what is spent on an elderly patient in the hospital but also for thirty days after discharge, when the patient visits a doctor or gets physical therapy for example.
Slashing what hospitals are paid does not eliminate “fraud, waste, and abuse,”contrary to what the law’s defenders claim. The cuts compel hospitals to operate in an environment of medical scarcity, with fewer nurses and less diagnostic equipment.
When Medicare cut payment rates to hospitals in 1997, the cuts eventually led to more deaths from heart attacks. Seniorstreated at the hospitals incurring the largest cuts had a 6-8% worse mortality rate from heart attacksthan seniors treated at other hospitals. The reason, researchers concluded, is that hospitals coped with the cuts by reducing nursing care. (National Bureau of Economic Research, March 2011.)
Though this research did not measure harm to younger patients, it is obvious that patients of every age suffer when nurses are spread thinner. Press the call button, and you will wait longer for help.
Medicare is the single largest source of revenue for hospitals. Richard Foster, Chief Actuary of Medicare and Medicaid Services, testified to Congress that the ObamaCare cuts will eventually force 40% of hospitals to operate at a loss, affecting the standard of care. Foster also cautioned that 15% of hospitals may stop accepting Medicare.
There are safer ways to control Medicare costs, including inching up the eligibility age, asking seniors to pay an affordable share of their bills, preventing hospital infections, and empowering patients to be cost-conscious consumers. Of course, politicians will try to claim that the easy answer -- slashing payments to hospitals -- won’t hurt patients, but the evidence shows that’s untrue.